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Home My WebLink AboutCAMPBELL POINT BLK 2 LT 7l l 2 [,Z 0 ooo Development Services Department Buiidinc Safety -Division On-Site Water ?c Wcstewater Program 4700 Bragew Street P.O. Box 196550 Mark Begich anchorage, A;Z 99519-66.50 Mayor aVanv. mi mi.orai ons i t (907)343-7904 Pump Installation Log Well Drilling Permit Number: SW_ Date of Issue: Parcel Identification Number: Legal Description Cr�, ►�� it 10C),h� rty Owner Name & Address: Pro e� Agjae. gyye) GJ AGK�tZ GrZ Pump Installation Date: ,r Pump Intake Depth Below Top of Well Casing: '��eet Pump Manufacturer's Name:S% Pump Model: e,�, s 2 Pump Size hp Pitless Adapter Burial Depth: Q feet Pitless Adapter Manufacturer's Name: Pitless Adapter Installer: Well Disinfected Upon Completion? Yes ❑ No Method of Disinfection: CLIP - Comments: A Anchorage Pum(P & Well Service Pump Installer Name: 330 East 76th Avenue Anchorage, Alaska 99516 Phone: 907-243-0740 Fax: 907-243-0742 attention: The pu np installer shall provide a pump installation log to the DSD within 30 days of pump installation. f¥ un c paIit z 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 GEORG£ M. SULLIVAN, MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION December 31~ 1980 John S. Berlin 7015 Weimer ~4 Anchorage, Alaska 99502 Permit # 800386 I subject: Lot 7 Block 2 Campbell Point Subdivision A permit issued by this department for well and/or sewer system has expired as of this date. Permits are issued on a cal~dar year basis, as stated on the permit, by authority of Municipal Ordinance. If you have drilled the well, a well log should be sent to this department to document the installation date. If an engineer inspected the installation of the on-site sewer system, please have them send us the as-builts for our files. If there are any further questions, please call this office at 264-4720. LNB/ljw enc: Copy of Permit SWP/057 PERMIT NO, MU~-I I C I PAL I TY OF DEPARTMENT ~"~ HEALTH AND ENVIRONMENTAL~,OTEOTION 825 %- STREET, ANCHORAGE, AK. 264-4?20 IWELI AND O~W--S I TE SE~WER PeRM < 8~8~ > APPLICANT JOHN S. BERLIN 7015 WEIMER 4 LOCATION 8440 WALKER CIR. TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH LOT SIZE 24~-~35 1~500 SQUARE FEET MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING (SQ FT/BR}= 85 THe REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: DEPTH= ~-~ LENGTH= 57 GRAYEl DEPTH= THE LENGTH DIMENSION IS THE LENGTH (IN FEET} OF THE TRENCH OR DRAINFIELD. THE DEPTH Of A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET}. THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET}. REQU I RED SePT I C TANK S I ZE= 1::~50 GALLONS PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THiS DEPARTMENT DURING THE INSTALLATION INSPECTIONS Of ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER Of RESIDENCES THAT THE WELL WILL SERVE. Tt-IO (~ 2 > ! NSPECT 'r ONS lire REQU I RED BACKFILLING Of ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR R PRIVATE WELL OR 150 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM R PRIVATE WELL TO R PRIVATE SEWER LINE IS 25 FEET AND TO R COMMUNITY SEWER LINE IS ?5 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DAYS Of THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS' Rte AVAILABLE TO INSURE PROPEr INSTALLATION. PeR~q I t exP ! RES DECEMBer ~-. ~.~$O I CERTIFY THAT i: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. SIGNED:_-~~. JOHN S. BERLIN V4. 0 .... MUNICIPALITY OF ANCHORAGE .~ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION POuch ~, ~,cho~l~, ~,~d~l 9gl6~2 276-222! SOILS LOG - PERCOLATION TEST PERCOLATION TEST PERFOF~MED LEGAL 7 10 13- 20 7 ENCOUNTERED? O P E SITE PLAN ~ ~,r ' , PERCOLATION RATE COMMENTS (minules/inch) TEST UN BE EEN F A O ~ FT 72/00~ (7/76) 2 ''- i,~D~ ]RECEIVED TIME TIME TIME MUNICIPALITY OF ANCHORAGE OF HEALTH & DEPAR~ENT OF HEALTH & ENVIRONMENTAL PRO~NM[NTAL ENVIRONMENTAL SANITATION DIVISION REGUEST FOR APPROVAL OF INDIVIDUAL WATE~ ~D SEWER FACILITIE~ 2. BUYER PHONE MAILING ADDRESS ~. REALTOR/AGENT I PHONE MAILING ADDRESS STHEET LOCATION ~ TYPE OF R~IOENCE NUMBER OF BEDROOMS 0 One ~ Four ~ ~ Two ~ Five SINGLE FAMILY ~ MULTIPLE FAMILY ~ Three ~ Six [] Other 7. WATER ~ INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled [] COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTI LITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE*' !(~:) YEAR ON-SITE SYSTEM WAS INSTALLED.. ' NOTE: THE INSPECTION FEE MUST A~OMPAN~ EACH REQUEST BEFORE PReenING CAN BE INITIATEE 72 010 (Rev, ~79) ~. ~ -L THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE [-1 SINGLE FAMILY F-I MULTIPLE FAMILY NUMBER OF BEDROOMS [] ONE [] THREE [] FIVE I-'1 TWO r-I FOUR [] SIX [] OTHER 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTI LITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM []INDIVIDUAL/ON -SITE r--IPURLIC UTILITY Connection Verified []SepticTank or [--IHoldingTank ' Size: If Tank is homem~cle ,ive dimensions: PERMIT NUMBER TOTAL ABSORPTION AREA 4. DISTANCES WELLT0: I Absorption Aree to neer~t Lot Line DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER IAb~orption Area ISewer Line INearest Lot Line DATEINSTALLED INSTALLER BOILS RATING TYPE OF TANK MANUFACTURER MATERIAL Sefltic/Holding Tank 5. COMMENTS 3ATE [~APPROVED FOR ~' BEDROOMS [] CONDITIONAL APPROVAL (letter must accompeny certificate) [] DISAPPROVEDISY ~____~. ~,~/~/~ ~/ 72.010 (Rev. 6/79) CHEMICAL & G~""x~OGICAL LABORATORIES ~"~' ALASKA, INC. TELEPHONE (907)-279-4014 ANCHORAGE INDUSTRIAl. CENTER 274-3364 5633 B Street Drinking water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: ~ -,,,,, ,', .--.-) I.D. NO. Water S~tem Name ! ~ Phone No. Mo. Dey year SAMPLE TYPE: I-I Routine I-I Check Sample (for routine sample with lab ref. no. t ri Special Purpose ri Treated Water [] Untreated Water SAMPLE · NO. I LOCATION Time ' Collected Collected By I TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: .~[~, Satisfactory I-'l Unsatisfactory r-I sample too long in transit; sample should not be over 48 hours old at examination to indicate reliable ~esults. Please send new sample. Date Received /" '''-~: ¢; '/ Time Received A~lytlcal Method: · ri Fermentation Tube ~ Membrane Filter Lab Ref. No. :'' ' .' '1 I I Result* Analyst FT':'I .r': '= READ INSTRUCTIONS BEFORE COLLECTING SAMPLE o~-122o (~) BACTER IOl,OG ICAL WATER ANAI,YSIS RECORD Rev. lg7I Directions for Coll:cting Samples of Water for ,', "- .................... !0',~ Coh,o~,,, B~c~e,m Examination ' ':"- :" This water an'~lys~s do~l~ With m~ter]~ls present in very mi~u~o quantJtJes.~ Carelessness in collecting and h~ndllng may lead to mis]~adin~'resuhs. '~ Water s~.mplos ~,¢i!1 have to reach the I;',borctory as quickly as possible within 48 hours after collection. After 48 hours, ,thc ~,ign;ficcnco of th? bacteriologic~,l analysis i3 imp~.rred and resampling will be nec- essory. Send to Laboratory fastcst w~,y: (i.e. sFecial delivery mail.) In co!!ecting sam, pies from TAPS or PUMPS proceed ~s folloWs: - ' .... :-" Remove an,/acrntgts or screens ~tt~.ched to th:i'~utlet.._: =; . r b) Thoroughly flush t~.p or pump by.~llowing water to run freely with a fully opened outlet for three dj Remove bo~l,: from ma'Jing ,ti be. Ho',d bottle in one hand while removing cap with the other. '- A~[d touch,no tho neck 0~ th~ bottle and thc ins~e of thc~cap. - ..... e) Fill the bottl~ to its shoulder wh~l? attcmptin~ to evoid sOla=h[ng. Immediately replace cap, being - -sure thatit~ '~ tight,-but not-s~ tight n5 Is *" form v./n ch ~s mS~c=t~ TO BE COMPlETED'BY'SUPPLIER." -- Fill in all apprc ~riate L,l~a:~ks carofufl~, includin7 your public water system identification number ~ID ~o.}. Contac the Alaska Department of EnvironmentaI Oon~e~ation if ~ou do not know ID number, wator.*uppliers only) The roquirc=~onts ~or an=lysis of public~atcr' sy~,-,z~,' "'~' ~ fo: total coliform bacteria are defined in the Drinf:in~ Water mgulntion= ndministcrcd by the' D=p2~mont 6f Environmental Consolation.